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Management and Outcomes of Tibial Eminence Fractures in the Pediatric Population: A Systematic Review

Background: Tibial eminence fractures (TEF) of Meyers–McKeever type II-III-IV usually require surgical management. No consensus in the literature has been achieved regarding the best treatment option. The aims of the present systematic review were (1) to analyze the current literature and describe t...

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Autores principales: Limone, Beatrice, Zambianchi, Francesco, Cacciola, Giorgio, Seracchioli, Stefano, Catani, Fabio, Tarallo, Luigi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10453829/
https://www.ncbi.nlm.nih.gov/pubmed/37628378
http://dx.doi.org/10.3390/children10081379
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author Limone, Beatrice
Zambianchi, Francesco
Cacciola, Giorgio
Seracchioli, Stefano
Catani, Fabio
Tarallo, Luigi
author_facet Limone, Beatrice
Zambianchi, Francesco
Cacciola, Giorgio
Seracchioli, Stefano
Catani, Fabio
Tarallo, Luigi
author_sort Limone, Beatrice
collection PubMed
description Background: Tibial eminence fractures (TEF) of Meyers–McKeever type II-III-IV usually require surgical management. No consensus in the literature has been achieved regarding the best treatment option. The aims of the present systematic review were (1) to analyze the current literature and describe the outcomes of surgical treatment for TEF; and (2) to compare the outcomes of different surgical options using arthroscopic reduction and internal fixation (ARIF) with sutures or screws and open reduction and internal fixation (ORIF). Methods: A search was carried out with Pubmed, Medline, and Cochrane. Key terms were used “tibial” AND “eminence” or “spine” or “intercondylar” AND “paediatric” or “children” AND “fracture” or “avulsion” AND “treatment”. Twelve articles met the inclusion criteria. Demographic data, clinical outcomes, and complication rates were evaluated for each study. Means/standard deviation and sum/percentage were used for continuous and categorical variables, respectively. Chi-square or t-student tests were applied. A p-value < 0.05 was considered statistically significant. Results: ORIF showed superior clinical outcomes (Tegner (p < 0.05) and Lysholm (p < 0.001) scores) relative to ARIF and a lower incidence of arthrofibrosis (p < 0.05) and implant removal (p < 0.01). The Tegner, IKDC, and Lysholm scores showed statistically significant superior results following arthroscopic sutures compared to arthroscopic screws (p < 0.001). The incidence of arthrofibrosis was higher after arthroscopic sutures (p < 0.05), the implant removal was higher after screw fixation (p < 0.001) Conclusions: Better clinical results with low complication rates were achieved with ORIF surgery rather than ARIF; arthroscopic suture fixation resulted in higher clinical results compared to arthroscopic screw fixation and reduced the incidence of postoperative complications.
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spelling pubmed-104538292023-08-26 Management and Outcomes of Tibial Eminence Fractures in the Pediatric Population: A Systematic Review Limone, Beatrice Zambianchi, Francesco Cacciola, Giorgio Seracchioli, Stefano Catani, Fabio Tarallo, Luigi Children (Basel) Systematic Review Background: Tibial eminence fractures (TEF) of Meyers–McKeever type II-III-IV usually require surgical management. No consensus in the literature has been achieved regarding the best treatment option. The aims of the present systematic review were (1) to analyze the current literature and describe the outcomes of surgical treatment for TEF; and (2) to compare the outcomes of different surgical options using arthroscopic reduction and internal fixation (ARIF) with sutures or screws and open reduction and internal fixation (ORIF). Methods: A search was carried out with Pubmed, Medline, and Cochrane. Key terms were used “tibial” AND “eminence” or “spine” or “intercondylar” AND “paediatric” or “children” AND “fracture” or “avulsion” AND “treatment”. Twelve articles met the inclusion criteria. Demographic data, clinical outcomes, and complication rates were evaluated for each study. Means/standard deviation and sum/percentage were used for continuous and categorical variables, respectively. Chi-square or t-student tests were applied. A p-value < 0.05 was considered statistically significant. Results: ORIF showed superior clinical outcomes (Tegner (p < 0.05) and Lysholm (p < 0.001) scores) relative to ARIF and a lower incidence of arthrofibrosis (p < 0.05) and implant removal (p < 0.01). The Tegner, IKDC, and Lysholm scores showed statistically significant superior results following arthroscopic sutures compared to arthroscopic screws (p < 0.001). The incidence of arthrofibrosis was higher after arthroscopic sutures (p < 0.05), the implant removal was higher after screw fixation (p < 0.001) Conclusions: Better clinical results with low complication rates were achieved with ORIF surgery rather than ARIF; arthroscopic suture fixation resulted in higher clinical results compared to arthroscopic screw fixation and reduced the incidence of postoperative complications. MDPI 2023-08-13 /pmc/articles/PMC10453829/ /pubmed/37628378 http://dx.doi.org/10.3390/children10081379 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Limone, Beatrice
Zambianchi, Francesco
Cacciola, Giorgio
Seracchioli, Stefano
Catani, Fabio
Tarallo, Luigi
Management and Outcomes of Tibial Eminence Fractures in the Pediatric Population: A Systematic Review
title Management and Outcomes of Tibial Eminence Fractures in the Pediatric Population: A Systematic Review
title_full Management and Outcomes of Tibial Eminence Fractures in the Pediatric Population: A Systematic Review
title_fullStr Management and Outcomes of Tibial Eminence Fractures in the Pediatric Population: A Systematic Review
title_full_unstemmed Management and Outcomes of Tibial Eminence Fractures in the Pediatric Population: A Systematic Review
title_short Management and Outcomes of Tibial Eminence Fractures in the Pediatric Population: A Systematic Review
title_sort management and outcomes of tibial eminence fractures in the pediatric population: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10453829/
https://www.ncbi.nlm.nih.gov/pubmed/37628378
http://dx.doi.org/10.3390/children10081379
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